nrnp 6675 week 1 discussion Certification and Licensure Plan
Certification and Licensure Plan
Now that you are in the final course in your program, it is time to turn in earnest to preparing for certification and licensure. You will need to take and pass the national PMHNP certification exam. Once certified, you will then be eligible to apply for licensure as an advanced practice registered nurse (APRN) in the state desired. It will be up to you to ensure you are knowledgeable about the practice agreements, scope of practice, and prescriptive authority in your state.
Although a movement called the APRN Consensus Model is attempting to standardize NP regulations nationally, it is still the case that requirements vary state to state. In some states, NPs may establish an independent practice without the supervision of an MD. Additionally, states are currently categorized as either allowing full practice, reduced practice, or restricted practice. Full practice states allow NPs to evaluate, order diagnostics, diagnose, and treat patients. They are licensed under the exclusive authority of the state board of nursing for the appropriate state. Many states may require prescriptive authority protocols in addition to collaborative agreement.
Another important area to consider and plan for is prescriptive authority. The appropriate board, which may be the medical board, state board of pharmacy, or nursing board, grants prescriptive authority under state law for the appropriate state licensure. The federal government grants the authority to write for a controlled substance, and the Drug Enforcement Administration (DEA) verifies this action through by the appropriate state board. Drug Enforcement Agency registration is granted at the federal level and has additional requirements/fees for the registration process.
In this Discussion, you will locate and review the practice agreements in the state in which you plan to practice, identify potential collaboration requirements in your state, and understand the certification and licensing process that you will need to follow.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
Review practice agreements in your state.
Identify whether your state requires physician collaboration or supervision for nurse practitioners, and if so, what those requirements are.
Research the following:
How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in your state?
What is the application process for certification in your state?
What is your state’s board of nursing website?
How does your state define the scope of practice of a nurse practitioner?
What is included in your state practice agreement?
How do you get a DEA license?
Does your state have a prescription monitoring program (PMP)?
How does your state describe a nurse practitioner’s controlled-substance prescriptive authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?
By Day 3 of Week 1
Post
a
summary of your findings on your state based on the questions listed above
. Explain the types of regulations that exist and the barriers that may impact nurse practitioner independent practice in your state. Be specific. Also, describe what surprised you from your research.
Read
a selection of your colleagues’ responses.
By Day 6 of Week 1
Respond
to at least
two
of your colleagues on
2 different days
in one or more of the ways listed below.
Share an insight from having viewed your colleagues’ posts.
Suggest additional actions or perspectives.
Share insights after comparing state processes, roles, and limitations.
Suggest a way to advocate for the profession.
Share resources with those who are in your state.
Note:
For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the
Reply
button to complete your initial post. Remember, once you click on
Post Reply
, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on
Post Reply
!
This topic is closed for comments.
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Ndidi Joan Egemonu
Dec 4, 2022 9:24pm
Reply from Ndidi Joan Egemonu
Week 1 Initial DQ.docx
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Neethu John
Dec 2, 2022 10:47pm
| Last reply Dec 3, 2022 3:45pm
Reply from Neethu John
How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in your state?
The state that I am planning to obtain certificate from is Texas and the Texas Board of Nursing will be the one to provide the license. At first the nurse has to complete the required amount of practicum hours and classroom hours and classes that would be meet the eligibility from an accredited school. The nurse must be licensed as a RN in the state of Texas. Then they must go through the endorsement process and fill and online application. (Texas Board of Nursing – education – Remediation Education, 2013).
What is the application process for certification in your state?
The nurses have to create an account through the Texas Nurse Portal and has to apply for the license online. The website is as follows. (Texas Board of Nursing – education – Remediation Education, 2013)
https://txbn.boardsofnursing.org/txbn
What is your state’s board of nursing website?
The link to the Texas Board of Nursing website is as follows: (Texas Board of Nursing – education – Remediation Education, 2013)
https://www.bon.texas.gov/index.asp.html
How does your state define the scope of practice of a nurse practitioner?
The Texas Board of Nursing recognizes APRN role as dynamic and the scope of practice evolves through experience, acquisition of knowledge, evidence-based practice, technology development and changes in the healthcare delivery system. It defines scope of practice as both Individual and professional scope of practice. (Texas Board of Nursing – education – Remediation Education, 2013).
Professional scope of practice is defined by scope according to each role such as documents that address the role, function, population served and practice setting. This is also the initial defining parameter for defining scope of practice. (Texas Board of Nursing – education – Remediation Education, 2013)
Individual scope of practice involves and changes in a positive direction with the professional maturity of the nurse. Individual scope of practice is impacted by clinical experience in various settings, continuation of nursing experience, formal course work and developments in healthcare and formal course work and developments. An advanced practice nurse cannot change his or her legally recognized titles or designations with just continuing education or experience, but it can only be achieved through formal education and legal formalities. Individual scope of practice has to be consistent with one’s professional scope of practice, statutory or regulatory laws, one’s education in the role and specialty, scope of one’s recognized title or does it evolve into another advanced practice title recognized by the board requiring additional formal education and legal recognition, Standards of Nursing Practice outlined in Board Rule 217.11, evidence-based care, reasonable and prudent practice and has to be willing to be accountable and liable to their own activity and outcome. (Texas Board of Nursing – education – Remediation Education, 2013)
What is included in your state practice agreement?
APRNs in the state of Texas cannot provide any medical aspects of care independently. It must be a collaborative relationship and a practice agreement with a physician. When providing medical care, Board Rule 221.13 requires advanced practice nurses to use written agreements to provide authority of care and delegation of authority to complete the medical certification for a death certificate or fetal death certificate should be included in the written document used by an Advanced Practice Nurse. . (Texas Board of Nursing – education – Remediation Education, 2013).
How do you get a DEA license?
To get a DEA license the APRN must have a prescriptive authority number that has been issued by Texas Board of Nursing and then the APRN must apply for the DEA license via the DEA website or by calling the DEA local office. (Texas Board of Nursing – education – Remediation Education, 2013)
DEA website is as follows: https://www.deadiversion.usdoj.gov/
Does your state have a prescription monitoring program (PMP)?
Texas has prescription monitoring program which requires all advanced practice nurses who prescribe benzodiazepines, opiates, barbiturates, or carisoprodol must check the PMP before prescribing any of these types of drugs beginning March 1, 2020. (Texas Board of Nursing – education – Remediation Education, 2013)
How does your state describe a nurse practitioner’s controlled-substance prescriptive authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?
Rule 222.8 describes the rules for prescribing drugs by APRN’s in the Texas Board of Nursing. APRN’s with full licensure and valid prescription authorization number are eligible to prescribe certain categories of controlled substances. Prescriptions and orders of Schedule III to V can be made if, a) prescription including refill shall not exceed a 90 – day supply, b) refill cannot be authorized without consulting with the authorizing physician and without adequate documentation in the chart. c) cannot prescribe for a child less than 2 years of age. Schedule II drugs can only be prescribed in a hospital-based setting with hospital bylaws and approval or in an emergency department or treatment plan. (Texas Board of Nursing – education – Remediation Education, 2013)
Reference
Texas Board of Nursing – education – Remediation Education. (2013). Retrieved December 2, 2022, from https://www.bon.texas.gov/rr_current/222-8.asp.html
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Cindy Mecham
(She/Her)
Dec 2, 2022 10:02pm
| Last reply Dec 3, 2022 10:51pm
Reply from Cindy Mecham
NRNP6675-23 Week 1 Discussion: Certification and Licensure Plan
Cindy Mecham
College of Nursing-PMHNP, Walden University
Dr. Madeline Reyes
11/30/22
Nurse Practitioner Practice Agreement in Hawaii
Hawaii defines the NPs scope of practice “NPs have full scope of practice authority (they assess, diagnose, and treat patients, including prescribing both controlled and uncontrolled drugs). They provide primary and specialty care in all practice settings, including ambulatory, acute, and long-term care.” NPs in Hawaii practice independently without obligatory physician collaboration or supervision
(
Hawaii Revised Statutes Chapter 457 NURSES [LAW]
, n.d.)
.
NPs receive board certification through ANCC and apply for licensure. This includes fingerprinting for a criminal history background check, government-issued ID, SSN, transcripts from the college attended, and a current Hawaii RN license
(
Hawaii Revised Statutes Chapter 457 NURSES [LAW]
, n.d.)
.
The application process for certification in Hawaii is to apply to sit for the ANCC PMHNP exam. This requires the submission of transcripts to ANCC. Once boards are passed you are certified, then apply for licensure in Hawaii.
(
Hawaii Revised Statutes Chapter 457 NURSES [LAW],
n.d.),
The Hawaii board of nursing website is
Links to an external site.
.
The following is included in the Hawaii state practice agreement: Requirements for licensure, including what is listed above, what is required for continued recertification (maintaining competencies through board certification with required CEUs), expected role and education requirements
(
Hawaii Revised Statutes Chapter 457 NURSES [LAW]
, n.d.)
.
A DEA license is obtained by completing an application at:
https://www.deadiversion.usdoj.gov/online_forms_apps.html
Links to an external site.
(
Diversion Control Division
. (n.d.). DEA Diversion. Retrieved November 29, 2022, from
https://www.deadiversion.usdoj.gov/online_forms_apps.html
Links to an external site.
)
Hawaii does have a prescription monitoring program (PMP) (
HI PMP AWARE
. (n.d.).
https://hawaii.pmpaware.net/login
Links to an external site.
.
Hawaii describes
a nurse practitioner’s controlled-substance prescriptive authority as: “
Prescribe and administer over-the-counter drugs, legend drugs, and controlled substances pursuant to this chapter and to chapter 329. . . “ All advanced practice registered nurses can receive prescriptive authority as long as there has been a criminal background check (fingerprinting). We can prescribe Schedule II-IV narcotics after receiving a DEA number and our state PDMP number
(
Hawaii Revised Statutes Chapter 457 NURSES [LAW]
, n.d.)
I’m a family nurse practitioner working on a postgraduate certificate as a PMHNP, so I’m already familiar with the information required for licensure. The one difficulty I’ve had in Hawaii is renewing the RN and APRN licenses. I am also licensed in Utah where they recognize the higher license, so it is much easier and more streamlined for license renewal.
There are no barriers to independent practice within the state regulations, but I have had certain payors require a physician’s signature for home health care (Medicare) which is frustrating.
References
Board of Nursing
. (n.d.). https://cca.hawaii.gov/pvl/boards/nursing/
Diversion Control Division
. (n.d.). DEA Diversion. Retrieved November 29, 2022, from
https://www.deadiversion.usdoj.gov/online_forms_apps.html
Links to an external site.
HI PMP AWARE
. (n.d.).
https://hawaii.pmpaware.net/login
Links to an external site.
Hawaii Revised Statutes Chapter 457 NURSES [LAW]
. (n.d.).
Links to an external site.
. Retrieved November 29, 2022, from
https://cca.hawaii.gov/pvl/files/2013/08/HRS_457-Nurses0716.pdf
Links to an external site.
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Safurat Olaniba-Adebisi
Dec 2, 2022 2:32pm
Reply from Safurat Olaniba-Adebisi
Discussion week #1
Main post
State of Illinois requires physician collaboration for APRN
In the state of Illinois APRN get certified by-passing board exam. Under Section 1300.400 Application for Licensure, the APRN then apply for license.
The application process for certification in state of Illinois:
File an application which must include Current RN license. Proof of current national certification with completion of examination and Proof of successful completion of a graduate degree appropriate for national certification.
Illinois Board of Nursing website
https://idfpr.illinois.gov
The scope of practice of a nurse practitioner
According to NCSL Scope of Practice Policy, APRN need a collaborating agreement with physician in writing to practice.
What is included in your state practice agreement?
State of Illinois requires APRN to have prescriptive authority outlined in the collaborative agreement. NPs may prescribe prescription drugs and Schedules III-V controlled substances.
How do you get a DEA license?
According to Drug Enforcement Administration, the APRN must have been issued a APRN license prior to DEA license, 45 graduate hours in pharmacology completed, permanent mailing address must be a street address, P.O.BOX is not accepted. The fee for DEA is $5.00, process must complete withing 3 years. (
DEA Diversion Control Division (usdoj.gov)
Links to an external site.
To obtain DEA license in the state of Illinois the collaborating physician need to submit a notice of prescriptive authority stating that APRN advanced has been delegated prescriptive authority and it includes Schedule II, III, IV, or V. Then, the APRN will be required to apply for a mid-level and will be on file with the Department before the issuance of a mid-level practitioner’s-controlled substances licensee. (State law)
State of Illinois have a prescription monitoring program (PMP)
How does your state describe a nurse practitioner’s controlled-substance prescriptive authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?
State of Illinois has a prescriptive authority for controlled substances Schedule II, III, IV, or V and the schedule prescribing must be included in the application for the DEA license, APRN cannot prescribe more than 30-day supply. (State Law)
References
Buppert, C. (2021).
Nurse practitioner’s business practice and legal guide
(7th ed.). Jones & Bartlett Learning.
Drug Enforcement Administration Diversion Control Division. (2020)
DEA Diversion Control Division (usdoj.gov)
Links to an external site.
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Kimberly Mary Baldor
Dec 2, 2022 12:07pm
| Last reply Dec 4, 2022 10:48pm
Reply from Kimberly Mary Baldor
nrnp6675baldorkimberlyweek1.pdf
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Shawn Osborne
Dec 1, 2022 9:39pm
| Last reply Dec 2, 2022 7:23pm
Reply from Shawn Osborne
Attempting to understand differing NP governing bodies, and what each is responsible for, takes some practice. There are federal and state organizations, and individual nursing boards that provide guidelines, laws, recommendations, and direction. While compiling information required for this assignment, I found that each website had clear directions for applying, and completing requirements, and offered direction and contact information to utilize as needed. In this post I will share what I found relating to Michigan rules and laws.
DEA, Licensing, and certification process in Michigan
The first step after graduation, is becoming nationally certified. ANCC and other organizations provide the testing, and have recommendations for studying and preparation. Once you have passed boards, licensure is applied for at www.michigan.gov/miplus, and is $55.00 for a specialty license. Steps to licensing include; a background check, a good moral character questionnaire, obtaining human trafficking education, providing social security number, and arranging RN license verification sent to the Bureau of Professional Licensing directly from your licensing body. (emailed to bpldata@michigan.gov or mailed to the Bureau of Professional Licensing, PO Box 30670, Lansing, MI). The next step is applying for a DEA number. NP’s that prescribe controlled substances under physician delegation, are required to register with the DEA. Applications to the DEA are made through the website: www.DEAdiversion.usdoj.gov. This application requires; your tax ID or social security number, proof of state licensing, a signed prescriptive authority agreement, and proof of your certification. The cost for three years is $888.00. An NPI number will need to be obtained if you bill medicaid or covered by HIPAA. An NPI is ten digits that becomes your unique identification code to payers, other providers, and within HIPAA transactions. Additionally, if the patient receives medicaid, you must go through screening and enrollment for the Community Health Automated Medicaid Processing System (CHAMPS) to received compensation. These two forms can be found at:
https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS10114.pdf
Michigan’s scope of practice defined
The Michigan council of nurse practitioners (MICNP) define a Nurse Practitioner as a health care provider (although state policy does not recognize an NP as a “provider”) that may practice under the supervision of a physician or independently, has completed advanced education with a minimum of a master’s degree, and has specialty certification. They may provide health care in a variety of settings such as acute care, long-term care, primary care, specialty care, and ambulatory care. They may diagnose, treat, prescribe, complete examinations, evaluate for health risks, provide education, promote wellness, provide referrals, and provide mental health treatment.
The Michigan scope of practice policy-state profile (n.d.) directs that NP’s my sign provider orders for life-sustaining treatment (POLST), sign scope of treatment forms, and perform any delegation within their scope of practice.
State practice agreement
Michigan is a restricted practice state, which according to the American Association of Nurse Practitioners (n.d.), is due to the inability of Nurse Practitioners to prescribe controlled substances, and directly bill state medical programs. The Michigan department of community health requires NP’s who will work with Medicaid, Michigan department of community health, or Children’s special health care services patients, and the collaborating physician to complete the NP/Physician collaborating agreement form which is accessed through the michigan.gov website at:
https://www.michigan.gov/-/media/Project/Websites/mdhhs/Folder1/Folder70/Dch-1575-NursePractitioner-Physician_Agreement-08-07.pdf
rev=75dfd38cc5564267864081c36af5b58a.
This agreement must consist of; specific guidelines in place to define the NP/physician collaboration presented in writing and including services provided and consultation and referral directions, agreement of collaboration guidelines, meetings between the NP and physician are scheduled for planning and evaluation, oral or written reports are formulated to evaluate the agreement, outcomes, and progress, documentation of NP/Physician consultation, and knowledge of patient needs in balance with the limits of authority and scope.
Participating with Michigan Medicaid and state medical programs requires the additional form DCH-1625, the Medical assistance provider and trading partner agreement, be completed and forwarded with the practice agreement. This form can be found at:
https://www.uslegalforms.com/jsfiller-desk17/?requestHash=79024eb357a9a8e891d55e941d4ea5bdfb1e344dcdffd08ec8da2b40b5ed57a2&lang=en&ref=https://www.uslegalforms.com&projectId=1166282074&loader=tips&MEDIUM_PDFJS=true&PAGE_REARRANGE_V2_MVP=true&isPageRearrangeV2MVP=true#9eb5bfbf7be740b9b20c12827cc93229
This restriction on practice, is a road block to independent NP practice in Michigan. The American Association of Nurse Practitioners (n.d.) has been lobbying with legislators in an effort to allow autonomous practice. Many states have adopted this form of practice, my state however, is not one of them. With independent practice, it would allow NP’s to more easily provide much needed care.
While obtaining information for this assignment, I was shocked and disturbed, when on the American Medical Association (AMA) website, I found a narrated podcast that described “practice creep, and scope creep” and discussed a group called Physicians for Patient Protection. These topics were aimed at NP and Physician assistants, and imply that patients are being harmed by our level of care as compared to a physician. This is upsetting, as we are driven to care for others and can fill a void in health care, by providing care that some may not otherwise be able to obtain. You can find it at the following site; https://www.ama-assn.org/practice-management/scope-practice/rebekah-bernard-md-importance-physician-led-care-podcast.
Prescriptive authority
Michigan legislature (n.d.) allows for NP’s to prescribe nonscheduled drugs autonomously. For schedule two through five drugs, (minus some schedule three drugs) or controlled substances to be prescribed by an NP, a physician must “delegate” the prescribing. This is covered under the NP/Physician practice agreement. The delegating physicians license and DEA number must also be provided on these controlled prescriptions. Suboxone and naltrexone can be prescribed by an NP as long as they complete a waiver, and the collaborating Physician has DEA X designation.
Michigan automated prescription system (MAPS)
The MAPS (n.d.) website allows controlled substances, and prescriptions to be monitored, and is helpful in preventing abuse and diversion. A history of medications, doses, quantity, prescriber, and date of retrieval is provided, and may be monitored by prescribers and pharmacies. Many providers are monitoring MAPS prior to each prescribing session to avoid harmful prescriptions.
Michigan state board nursing website
https://www.michigan.gov/lara/bureau-list/bpl/health/hp-lic-health-prof/nursing
References
Dea diversion control division
. (n.d.). Retrieved November 29, 2022, from
https://www.deadiversion.usdoj.gov/index.html
Links to an external site.
Mi automated prescription system (maps)
. (n.d.). Retrieved November 29, 2022, from
https://www.michigan.gov/lara/bureau-list/bpl/health/maps
Links to an external site.
Michigan
. (n.d.). American Association of Nurse Practitioners. Retrieved November 29, 2022, from
https://www.aanp.org/advocacy/michigan
Links to an external site.
Michigan council of nurse practitioners
. (n.d.). MICNP. Retrieved November 29, 2022, from
https://micnp.org/page/resources
Links to an external site.
Michigan legislature – home
. (n.d.). Retrieved November 29, 2022, from
http://www.legislature.mi.gov/(S(tlhzlwsj1di4do11ek5qyziu))/mileg.aspx?page=Home
Links to an external site.
Michigan scope of practice policy – state profile
. (n.d.). Scope of Practice Policy. Retrieved November 29, 2022, from
https://scopeofpracticepolicy.org/states/mi/
Links to an external site.
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Colette Affiah
Dec 1, 2022 3:28am
| Last reply Dec 1, 2022 5:44am
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How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in your state?
I am a resident of North Carolina and am interested in being a licensed practitioner in the State of North Carolina to function as an advanced nurse practitioner. To be able to apply for the certification and licensure to practice as an advanced practice Registered Nurse (APRN), one must complete a master’s degree or a higher degree in Nursing with a primary focus on Nursing and attend an educational instruction in a nationally accredited educational system. The joint subcommittee of the Medical Board and the board of Nursing regulates the certification process. Certification is completed by the national credential bodies approved by the board. The APRN must undergo the certification process by one of the national credentialing bodies supported by the board of Nursing. The various credentialing bodies involved are the American Nurses Credential Center (ANCC), the American Academy of Nurse Practitioners (AANP), the American Association of Critical Care Nurses Certification Corporation (AACN), National Certification Corporation of the obstetric Gynecological and Neonatal Nursing Specialties (NCC) and Pediatric Nursing Certification Board (PNCD). After completing the educational program in an accredited educational institution, the individual will have to take the board examination after the application is complete to take the board examination to gain the license to practice as an advanced nurse. (Retrieved from NCBON
https://www.ncbon.com
Links to an external site.
)
The initial stage of application to receive certification
The initial stage of application to get a certification is applying for Registration which does not give the Nurse the right or authority to practice as a North Carolina Practitioner in North Carolina. After the one-time Registration, the Nurse will complete the initial approval to Practice application. The certificate of Registration is emailed to the Nurse after completing the application process. (Retrieved from NCBON
https://www.ncbon.com
Links to an external site.
)
What is the application process for certification in your state?
To Practice in the State of North Carolina, one must be an active permanent North Carolina Registered Nurse or have a license with a multistate privilege from another compact state. Compact State application via the Nurse gateway Portal must be submitted. Initial application to gain approval to Practice will be applied with a fee of $100, which is non-refundable before approval can be given. This will grant authorization by the medical board and the Board of Nursing for an advance practiced registered Nurse to perform medical acts within the scope of the educational preparedness and certification under a collaborative practice agreement with a licensed Physician. The APRN can only have the right to start practicing after the notification of approval to practice has been given to the advanced Nurse by the State Board of Nursing. The Nurse must seek permission to practice with their collaborating and supervising practitioner. To apply for this authorization, the Physician, name, License number, email address, and Practice information, including the Practice name, address, and office phone number, are required to complete the application process. (Retrieved from NCBON
https://www.ncbon.com
Links to an external site.
)
What is your state’s board of nursing website?
North Carolina State Board of Nursing is https://www.ncbon.com.
How does your state define the scope of Practice of a nurse practitioner?
The population-focused Nurse Practitioner’s scope of Practice is defined by the Nurse Practitioner’s formal academic, graduate educational preparation, national certification, and maintained competence. The Collaborative Practice Agreement (CPA) operationalizes the scope of Practice. (Retrieved from NCBON
https://www.ncbon.com
Links to an external site.
)
What is included in your state practice agreement?
There is no specific format that the agreement can be based. Still, in the primary supervising Physician’s Collaborative Practice Agreement (CPA), the rules will be operated to agree with the administrative code and regulations. Because regulations differ from Practice to practice, the Collaborative Practice Agreements will also vary depending on the patients in that practice setting. The practice agreement is also based on how complex the care the patients receive and whether there is an emergency attached to the practice setting. Moreover, the level of experience of the Advanced practice nurse also determines what will be included in the practice agreement. There must be an arrangement for ongoing supervision, consultation, collaboration, referral, and evaluation of care delivery by the Nurses Practitioner. The Supervising practitioner must address how they will practice together. All this completed document is the Nurse Practitioner Collaboration Practice Agreement. (Retrieved from NCBON
https://www.ncbon.com
Links to an external site.
)
How do you get a DEA license?
Before being able to write prescriptions for a controlled substance, an advanced practice nurse must apply online to the United States Department of Justice. A call can be placed to 1800-882-9359 or by calling the nearest DEA Registration Field Office to request a physical copy of the order form. Forms are usually mailed within ten working days. Select your application method, either an online or a paper application, but online is recommended. You can assess the application at
https://apps.deadiversion.udoi.gov/webforms/isp/regapps/common/newAppLogin.jsp
Links to an external site.
, select the business category as “Analytical Lab” located under form 225, and click the begin button. Complete your application by ensuring that Personal and business information are both provided. You will have to provide the license information by including the state license number, State license state, and expiring state and state-controlled substance information, including the number and expiring date. (Retrieved from NCBON
https://www.ncbon.com
Links to an external site.
)
Does your state have a prescription monitoring program (PMP)?
North Carolina has the North Carolina Controlled Substances Reporting System (NC CSRS) involved in monitoring controlled substances on schedules 11, 111, IV, and V. Data must be reported for both the administration and dispensing of naloxone. The Prescription drug Monitoring Program warrants enrollment and the use of the PDMP for prescribers and dispensers. (Retrieved from NCBON
https://www.ncbon.com
Links to an external site.
)
How does your state describe a nurse practitioner’s controlled-substance prescriptive authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe
The prescriptive authority is part of the Nurse Practitioner’s approval to Practice. The nurse practitioner may prescribe controlled substances and refill consistently with controlled substance laws and rules; Schedule 11 controlled substances cannot be filled, schedule 11 and 1V controlled substances may be refilled up to five times in six months, and scheduled V controlled substances may be refilled as authorized by the practitioner. The Nurse practitioner can prescribe controlled substances and must apply for DEA registration to prescribe a controlled substance. The supervising Physician must have a DEA registration equal to or greater than the Nurse they supervise. Controlled substances (Schedules II, IIN, III, IIIN, IV, V) may be prescribed or ordered as written in the written protocols as long as the following are met: DEA number must be included on each controlled substance prescription. Dosage units for Schedule II, IIN, III, and IIIN are limited to a thirty-day supply. No refills are allowed on Schedule II. (Retrieved from NCBON
https://www.ncbon.com
Links to an external site.
)
Because Advanced practice nurse in North Carolina has restrictive Practice, it will impact how the APRN delivers care to the patient. According to Peterson (2017), the restrictive level practice involves close supervision, delegation, and management of care by an outside health discipline with any care delivery by the APRN. As noted by Peterson, this restriction placed on the practitioners will limit the care patients receive as advanced nurses cannot practice to their full potential. Nurse Practitioners experience barriers that may help provide more access to healthcare, thereby limiting the increased number of hospitalizations that patients may encounter. It may also impact the advanced Nurse due to the restrictive scope of Practice, as Hain et al. (2014) posited. It may result in more stringent payer policies, reducing the effectiveness of the advanced Nurse’s capacity to practice.
I was intrigued to learn of the different steps of application that an advanced practice nurse requires to be able to practice, I also was pleased to know about the DEA licensure before prescribing controlled substances and I also learned that some states have valued the advanced practice role in healthcare and given reduced Practice with less supervision to the NP as against the restrictive rule that is allowed for the scope of Practice in North Carolina which is my state of residence.
References
Hain, D., & Fleck, L. (2014). Barriers to nurse practitioner practice that impact healthcare
redesign.
The Online Journal of Issues in Nursing
,
19
(2). DOI:10.3912/OJIN.Vol19No02Man02
https://doi.org/10.3912/OJIN.Vol19No02Man02
Links to an external site.
Retrieved from North Carolina State Board of Nursing
https://www.ncbon.com
Links to an external site.
Peterson ME. Barriers to Practice and the Impact on Health Care: A Nurse Practitioner Focus. J Adv Pract Oncol. 2017 Jan-Feb;8(1):74-81. Epub 2017
Jan 1. PMID: 29900018; PMCID: PMC5995533.
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Pamela Mccleary
Nov 30, 2022 11:41pm
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Cindy Mecham
(She/Her)
Nov 30, 2022 10:36pm
| Last reply Dec 6, 2022 2:23am
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NRNP6675-23 Week 1 Discussion: Certification and Licensure Plan
Cindy Mecham
College of Nursing-PMHNP, Walden University
Dr. Madeline Reyes
11/30/22
Nurse Practitioner Practice Agreement in Hawaii
Hawaii defines the NPs scope of practice “NPs have full scope of practice authority (they assess, diagnose, and treat patients, including prescribing both controlled and uncontrolled drugs). They provide primary and specialty care in all practice settings, including ambulatory, acute, and long-term care.” NPs in Hawaii practice independently without obligatory physician collaboration or supervision.
NPs receive board certification through ANCC and apply for licensure. This includes fingerprinting for a criminal history background check, government issued ID, SSN, transcripts from the college attended, and a current Hawaii RN license.
The application process for certification in Hawaii is to apply to sit for the ANCC PMHNP exam. This requires submission of transcript to ANCC. Once boards are passed you are certified, then apply for licensure in the state of Hawaii.
The Hawaii board of nursing website is
Links to an external site.
.
The following is uncluded in he Hawaii state practice agreement: Requirements for licensure, including what is listed above, what is required for continued recertification (maintaining competencies through board certification with required CEUs), expected role and education requirement.
A DEA license is obtained by completing an application at: https://www.deadiversion.usdoj.gov/online_forms_apps.html
Hawaii does have a prescription monitoring program (PMP).
Hawaii describes describes a nurse practitioner’s controlled-substance prescriptive authority as : “Prescribe and administer over the counter drugs, legend drugs, and controlled substances pursuant to this chapter and to chapter 329. . . “ All advanced practice registered nurses can receive prescriptive authority as long as there has been a criminal background check (fingerprinting). We can prescribe Schedule II-IV narcotics after receiving a DEA number and our state PDMP number.
I’m a family nurse practitioner working on a post graduate certificate as a PMHNP, so I’m already familiar with information required for licensure. The one difficulty I’ve had in Hawaii is having to renew both the RN and APRN licenses. I am also licensed in Utah where they recognize the higher license so it is much easier and more streamlined for license renewal.
There really are no barriers in independent practice within the state regulations, but I have had certain payors require a physician signature for home health care (Medicare) which is frustrating.
NRNP6675-23 Wk1Assgn1MechamC.pdf
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Willie Feagin
Nov 30, 2022 10:19pm
| Last reply Dec 3, 2022 6:34am
Reply from Willie Feagin
Week 1 Discussion Post
Identify whether your state requires physician collaboration or supervision for nurse
practitioners. Review practice agreements in your state. Nurse practitioners (NP) practicing in Georgia must work under physician supervision. NPs and their physician supervisors must work together under a “nurse protocol”. The nurse protocol is a written document in which the physician gives the NP authority to perform medical acts and also agrees to be available for immediate consultation with the nurse practitioner. Georgia state law refers to this supervising physician as a “delegating physician”. In Georgia, the delegating physician is held legally responsible for all medical acts performed by the NP (ANPSP, 2017). Currently, in Georgia, a nurse practitioner’s ability to prescribe must be outlined in the nurse protocol agreement between the NP and MD. NPs in Georgia are not allowed to prescribe Schedule II controlled substances. Nurse practitioners are allowed to sign their prescriptions in Georgia and do not need an MD co-signature. Nurse practitioners are allowed to sign handicap parking permits but are not permitted to sign death certificates. In Georgia are required to be immediately available for consultation with the NP. Should the physician not be available, a substitute may be designated as part of the nurse practice agreement. Delegating physicians are also responsible for conducting a review of medical records for patients treated by the NP as well as observing the nurse practitioner onsite at least quarterly. Aside from this quarterly visit, the physician does not need to practice onsite with the NP, just be available for consultation (
Nurse Practitioner Scope of Practice: Georgia
, n.d.).
How do you get certified and licensed as an Advanced Practice Registered
Step 1. Get Your Graduate Degree
You must have a master’s degree or higher in nursing or in a specialty area of advanced practice registered nursing to be eligible for APRN authority in Georgia.
Step 2. Earn Your National Certification
The Georgia Board of Nursing authorizes four types of APRNs. You must become nationally certified in the APRN general area of specialty in which you wish to practice. Independent national certification agencies exist to facilitate this process, each one setting its requirements regarding education, experience, and examination.
Step 3. Apply for your Authorization
Under state and federal law, your social security number must be disclosed on your application for APRN authorization. In doing so, you are granting consent for your social security number to be made available to the National Practitioner’s Databank (NPDB), the Healthcare Integrity and Protection Data Bank (HIPDB), other licensing boards, and other regulatory agencies for licensure track.
File the Application for Authorization as an Advanced Practice Nurse. Be sure to check the box corresponding to the general area of specialty for which you are applying. If you seek more than one APRN authorization, you must submit a separate application for each APRN authorization you wish to obtain.
Step 4. Renewing Your Authorization
Your Georgia APRN authorization expires biannually on January 31st of odd-numbered years simultaneous with the expiration of your RN license.
What is the application process for certification in your state?
Application forms are available for download from the Board website (http://sos.ga.gov/index.php/licensing/plb/45/authorization_as_an_aprn).
CNS and NP applicants will note on the application the type of nurse practitioner or clinical nurse specialist practice that corresponds with their preparation.
A certification verification form is included in the application packet. The licensing agency asks that the certification agency submit verification via email to the address listed in the packet.
The transcript is to be included in the packet in a sealed envelope.
Applicants who answer “yes” to questions about legal convictions or board disciplinary actions will need to provide detailed letters of explanation as well as supporting documents.
Noncitizens will include a copy of a document that establishes qualified alien status.
The application fee is $60.
Application forms require notarization.
Required materials should be sent together in a nine-by-twelve envelope to the Board office in Macon.
The licensing agency communicates primarily by email. Applicants can monitor their status online.
What is your state’s board of nursing website?
www.sos.ga.gov, Georgia Board of Nursing
How does the state of Georgia define the scope of practice of a nurse practitioner?
The nurse practitioner provides advanced practice nursing care and medical services specific to the nurse practitioner’s respective specialty to individuals, families, and groups, emphasizing health promotion and disease prevention as well as the diagnosis and management of acute and chronic diseases. The nurse practitioner collaborates as necessary with a variety of individuals to diagnose and manage clients’ health care problems. The nurse practitioner practices in a manner consistent with the nationally recognized nursing practice standards for the respective nurse practitioner specialty that is consistent with the Board-recognized national certification organization identified in Rule 410-11-.12.
What is included in your state practice agreement?
, In Georgia, a nurse practitioner’s ability to prescribe must be outlined in the nurse protocol agreement between the NP and MD. the delegating physician gives the NP authority to practice medical procedures and agrees to be available to the NP for consultation (ANPSP, 2017). The physician has to review all medical records of the NP’s patients. NP must have quarterly on-site observation by delegating physicians.
How do you get a DEA license?
As an NP who administers, prescribes, or dispenses any controlled substance, you must be registered with the federal Drug Enforcement Administration (DEA).
To obtain the official order form, you may:
Apply online at the U.S. Department of Justice website. This resource is only available to new applicants.
Call the DEA Headquarters Registration Unit toll-free at 800-882-9539 or call your nearest DEA Registration Field Office to request a physical copy of the order form. Forms will be mailed within 10 working days.
Submit a completed requisition form—DEA Form 222a, which is mailed to a registrant approximately 30 days after each shipment of DEA Forms 222—to DEA, Registration Unit, P.O. Box 28083, Washington, D.C. 20038-8083.
Does your state have a prescription monitoring program (PMP)?
The Prescription Drug Monitoring Program (“PDMP”) is an electronic database used to monitor the prescribing and dispensing of controlled substances. Under O.C.G.A. § 16-13-57(c) if you hold an active DEA number, whether you prescribe controlled substances or not, you MUST register with the PDMP. The PDMP is meant to help eliminate overprescribing of controlled substances & provide medical professionals with critical information regarding a patient’s prescription history to identify and protect those at risk of abuse (
Prescription Drug Monitoring Program: Georgia State Profile
, n.d.). The PDMP was started on 13 July 2013.
How does your state describe a nurse practitioner’s controlled-substance prescriptive authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?
Nurse practitioners in the state may only prescribe schedule III-V drugs. Prescribing of schedule II substances is limited to physicians. Nurse practitioners are allowed to sign their prescriptions in Georgia and do not need an MD co-signature. A written prescription drug order issued under this Code section shall be signed by the advanced practice registered nurse and shall be on a form that shall include, without limitation, the names of the advanced practice registered nurse and delegating physician who are parties to the nurse protocol agreement, the patient’s name and address, the drug or device ordered, directions about the taking and dosage of the drug or use of the device, and the number of refills.
Some of the barriers that an NP has in Georgia are policy restrictions on the practice, poor physician relations, poor administrator relations, and others’ lack of understanding of the APRN role.
Reference
Advanced Nurse Practitioner Supervision Policy (ANPSP). (2017, July).
https://j2vjt3dnbra3ps7ll1clb4q2-wpengine.netdna-ssl.com/wp-content/uploads/2017/07/Advanced-Nurse-Practitioner-Supervision-Policy.pdf
Links to an external site.
Become a Nurse Practitioner in Georgia | APRN License Requirements in GA – NursingLicensure.org. (2021, September 21).NursingLicensure.Org. Retrieved February 24, 2022, from
https://www.nursinglicensure.org/np-state/georgia-nurse-practitioner/
E. (2020, March 25).
Nurse Practitioner Scope of Practice: Georgia. ThriveAP. Retrieved February 24, 2022, from
https://thriveap.com/blog/nurse-practitioner-scope-practice-georgia
How to Get Information About Obtaining a DEA Number. (n.d.). American Association of Nurse Practitioners. Retrieved February 24, 2022, from
https://www.aanp.org/practice/practice-management/business-resources-for-nurse-practitioners/how-to-order-a-dea-number
Prescription Drug Monitoring Program. (2021, September 2). Georgia Department of Public Health. Retrieved February 24, 2022, from
https://dph.georgia.gov/pdmp#:%7E:text=The%20Georgia%20Prescription%20Drug%20Monitoring,and%20dispensing%20of%20controlled%20substances.
Registration Procedures. (n.d.). US Department of Justice. Retrieved February 24, 2022, from
https://www.deadiversion.usdoj.gov/drugreg/process.htm
Links to an external site.
2019 Georgia Code:: Title 43 – Professions and Businesses:: Chapter 34 – Physicians, Acupuncture, Physician Assistants, Cancer and Glaucoma Treatment, Respiratory Care, Clinical Perfusionists, and Orthotics and Prosthetics Practice:: Article 2 – Medical Practice:: § 43-34-25. Delegation of certain medical acts to advanced practice registered nurses; construction and limitations of such delegation; definitions; conditions of nurse protocol; issuance of prescription drug orders. (n.d.). Justia Law. Retrieved February 24, 2022, from
https://law.justia.com/codes/georgia/2019/title-43/chapter-34/article-2/section-43-34-25/
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Sward Kamarah
Nov 30, 2022 9:39pm
| Last reply Dec 3, 2022 7:21am
Reply from Sward Kamarah
Week 1 Discussion
Nurse practitioners must familiarize themselves with practice agreements, the scope of practice, and prescriptive authority in the states they plan to practice nursing. This paper identifies potential collaboration requirements in Maryland (the State I plan to practice). The paper also describes the certification and licensing process and the scope of practice of a nurse practitioner. In Maryland, an Advanced Practice Registered Nurse (APRN) is certified and licensed to practice by the Maryland Board of Nursing. The
Code of Maryland Regulations
(COMAR) requires applicants to submit their compact State (permanent address) registered nurse license and the nurse practitioner application (American Association of Nurse Practitioners, 2020). The Maryland Board of Nursing reviews and approves all Nurse Practitioner Programs before certifying applicants as Advanced Practice Nurses.
The application process for certification in Maryland involves obtaining required materials (clinical history record check and tracking number), completing an online application form and an institutional verification identification form, submitting an authorization to test request, and completing the NCLEX-RN examination (American Association of Nurse Practitioners, 2020). Applicants await certification from the Maryland Board of Nursing.
My State’s board of nursing website is mbon.Maryland.gov. Maryland has no limits for the scope of practice of a nurse practitioner. It is designed as a full-practice state (American Association of Nurse Practitioners, 2022). Maryland licensure allows nurse practitioners to assess, diagnose, treat, and evaluate patients. Nurse practitioners can also order diagnostic tests and write prescription orders. This State allows nurse practitioners to practice independently without supervision. Therefore, nurse practitioners can provide nursing services across various healthcare settings and even in other states (American Association of Nurse Practitioners, 2022). Additionally, nurse practitioners with a multi-state license can practice in participating states in any of the twenty-five National Nurse Licensure Compact.
The practice agreement includes an agreement that verifies that a nurse practitioner has a physician lined up to consult and collaborate when necessary. For instance, nurse practitioners can refer patients to a specialist. Therefore, Maryland nurse practitioners have strong collaborative relationships with multiple interdisciplinary team members (Zhang et al., 2021). Nurse Practitioners require a Maryland state-controlled dangerous substances number to get a Drug Enforcement Administration (DEA) license. The practitioners apply for DEA licenses online through the U.S. Department of Justice website (United States Department of Justice Drug Enforcement Administration, 2022). Applicants also require an active practicing license in the compact State.
Maryland state has a prescription monitoring program (PMP) to improve patient safety and assist medical, pharmacy, and public health providers in using prescription drugs. PMP monitors drugs that contain controlled substances Schedules II, III, IV, and V by collecting and storing the information of drugs being dispensed (refill number, refill information, National Drug Code, date refill number was issued and filled, quantity dispensed, days’ supply), patient, prescriber and dispenser (Maryland Department of Health, 2022). PMP is a strategy for reducing prescription drug abuse and improving patient safety.
The state board of nursing provides an exclusive licensure authority for nurse practitioners to prescribe medications, including controlled-substance drugs (CDS) (Zhang et al., 2021). Nurse practitioners are required to follow the PMP protocol in the prescription of CDS. Additionally, these healthcare providers must have a Maryland drug control number for authorization to prescribe drug schedules. In essence, Maryland is a full-practice state that allows nurse practitioners to prescribe medications with autonomy.
References
American Association of Nurse Practitioners. (2020, September 12).
Advanced Practice Registered Nursing: Nurse Practitioners
. mbon.maryland.gov.
https://mbon.maryland.gov/Pages/adv-prac-nurse- practitioner-index.aspx
Links to an external site.
American Association of Nurse Practitioners. (2022, October 10).
State Practice Environment
.
https://www.aanp.org/advocacy/state/state-practice-environment
Links to an external site.
Maryland Department of Health. (2022).
Prescription Drug Monitoring Program – FAQs
. Maryland.gov.
https://health.maryland.gov/pdmp/Pages/- PDMP_FAQs.aspx
Links to an external site.
United States Department of Justice Drug Enforcement Administration. (2022).
DEA Forms and Applications
.
https://www.deadiversion.usdoj.gov/online_forms_apps.html
Links to an external site.
Zhang, P., & Patel, P. (2021). Practitioners And Prescriptive Authority. In
StatPearls [Internet]
. StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK574557/
Links to an external site.
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Jennifer Lisa
Nov 30, 2022 9:05pm
| Last reply Dec 2, 2022 8:10pm
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NRNP 6675 Week 1 Discussion
NRNP 6675 WK 1 Discussion Post.docx
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Tina Baker
Nov 30, 2022 8:12pm
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WK1Assgn+Baker+T6675.docx
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Chasity Cooper
Nov 30, 2022 3:52pm
| Last reply Dec 1, 2022 5:42am
Reply from Chasity Cooper
Alabama Board of Nursing
Chasity Cooper RN, BSN
PMHNP Across Lifespan II Pract-Winter 2022
Walden University
Dr. Reyes
11/29/22
Alabama Board of Nursing
Walden University’s nurse practitioner program has taught me a great deal of information so far. I am excited to enter the 6675 course this semester. I look forward to gaining the final knowledge to prepare me for life after graduation. I have not decided my final decision for where I would like to practice; however, I currently reside in Alabama. The purpose of this paper is to discuss the process of becoming a certified nurse practitioner and the Alabama Board of Nursing guidelines.
The Alabama Board of Nursing is the governing authority that sets and enforces the rules and regulations practiced as a nurse. The Alabama Board of Nursing is led by the executive officer Peggy Sellers Benson, RN, MSHA, MSN, NE-BC and roughly 13 other board members (Abn.alabama.gov, n.d.). Common questions about the Alabama Board of Nursing can be answered on their website abn.alabama.gov. The nurse population is growing more rapid than the physician population. According to Mark and Patel (2019), the nurse practitioner population increased by nearly ten percent compared to only about a one percent increase in doctors.
The first step in becoming an advanced practice nurse is to obtain a graduate degree. The graduate degree must be accredited by the U.S. Department of Education or the Council of Higher Education Accreditation. The next step is to become nationally certified. The Alabama Board of Nursing requires certification through the American Nurses Credentialing Center (
Become RN Nurse
, 2022). Once the test for certification has been taken, an application for a certificate must be completed. To maintain the certification the board requires a renewal fee and documents every two years (
Become RN Nurse
, 2022).
The scope of practice of nurse practitioners can vary from state to state. Nearly 30 states have given their nurse practitioner’s the ability to prescribe medications without a physician (Muench et al., 2021). According to Hart and colleagues (2020), the state of Alabama is a reduced practice state. The Joint Committee of Alabama Board of Medical Examiners and the Alabama Board of Nursing must approve any collaborative relations with a physician. Alabama has preset regulations on controlled substances that can be prescribed by nurse practitioners. Alabama nurse practitioners must use a collaborative physician (Hart et al., 2020). In Alabama a nurse practitioner must wait a year after receiving the collaborative before they can apply for the ability to prescribe controlled substances. The Alabama Department of Public Health plays a huge part in monitoring prescription drugs and keeping a record of the drugs dispensed to patients. The application to apply for the Qualified Alabama Controlled Substance Certificate can be accessed at
www.albme.org/qacscupdate.html
Links to an external site.
. According to the Board of Nursing website certified nurse practitioners are allowed to prescribe controlled substances in schedules III, IV, and V (Abn.alabama.gov, n.d.).
Conclusion
The nurse practitioners I have encountered so far have been very open about their experiences in prescribing controlled substances in multiple states. I am not surprised by the state of Alabama’s rules and regulations for practice. Hopefully one day Alabama will join the union with the more independent states. This assignment has made me more aware of regulations I was not aware of.
References
Abn.alabama.gov. (n.d.). Retrieved November 30, 2022, from https://www.abn.alabama.gov/
Become RN nurse in Alabama + Requirements & Licensing
. NurseJournal. (2022, July 6). Retrieved November 29, 2022, from https://nursejournal.org/state/alabama/nurse-licensing-requirements/
Hart, L., Ferguson, R., & Amiri, A. (2020). Full Scope of Practice for Alabama Nurse Practitioners: Act Now.
The Journal for Nurse Practitioners
,
16
(2), 100-104.
Mark, B. A., & Patel, E. (2019). Nurse practitioner scope of practice: what do we know and where do we go?.
Western Journal of Nursing Research
,
41
(4), 483-487.
Muench, U., Whaley, C., Coffman, J., & Spetz, J. (2021). Scope-of-practice for nurse practitioners and adherence to medications for chronic illness in primary care.
Journal of general internal medicine
,
36
(2), 478-486.
Alabama Board of Nursing.docx
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Solange Ndah Missibi
Nov 30, 2022 3:15pm
| Last reply Dec 2, 2022 10:43pm
Reply from Solange Ndah Missibi
Week 1 Discussion Post
Washington DC, or the District of Columbia, is a part of the American Association of Nurse Practitioners (AANP) Region 3 which includes five other US states (DE, MD, PA, VA WV) with full practice authority for nurse practitioners (NPs) (AANP, 2022). Thereby allowing them to diagnose, treat, and evaluate patients with mental disorders, including prescribing medications as well as controlled substances under the exclusive licensure authority of the state board of nursing (AANP, 2020).
To qualify for APRN licensure in DC, first, you must have enrolled and graduated from a college or university with an advanced practice nursing degree. After which, the licensing process includes; completing an application for state licensure and paying the required fees. Secondly, submitting and verifying your original state of licensure and all other licenses, and thirdly getting fingerprinted, completing a background check, as well as meeting all requirements by the board (DC Health, 2022).
DC state’s board of nursing website: https://dchealth.dc.gov/page/board-nursing
The DC state agreement includes providing and setting licensure fees, criminal background check requirements, stipulated regulations or code of conduct, setting educational standards/requirements, enforcing regulatory laws, and taking disciplinary processes, as well as collecting and analyzing nursing workforce data (AANP, 2022). For example, in DC, for an NP to have prescriptive authority, they must be certified and comply with all applicable DC and federal laws (DC Health, 2022).
To obtain a DEA license, one can apply online at the Department of Justice website or fill out the necessary form 222a and mail it to the DEA registration unit in Washington, DC (DEA, 2020).
Yes, DC has a PMP requiring all DC licensed prescribers must register with the DC PDMP (DC Health, 2022).
NPs in DC have the authority to prescribe Schedules II through V drugs; however, all controlled substances prescribers must be licensed, certified and have a valid controlled substances certificate of registration from the DEA as well as a valid DC controlled substances registration according to the District of Columbia Uniform Controlled Substances Act (DC Health, n.d.).
References
American Association of Nurse Practitioners (AANP). (2022). District of Columbia Information and Resources for District of Columbia NPs. Retrieved from https://www.aanp.org/advocacy/district-of-columbia
American Association of Nurse Practitioners. (2020). State practice environment Links to an external site. Retrieved from https://www.aanp.org/advocacy/state/state-practice-environment
DC Health. (2022). APRN Application Documents. Retrieved from https://dchealth.dc.gov/publication/aprn-application-documents
DC Health. (n.d.). Municipal Regulations for Nurse Practitioners. Retrieved from https://dchealth.dc.gov › doh › nurse practitioner
Drug Enforcement Administration Diversion Control Division (DEA). (2020). Registration Links to an external site. Retrieved from https://www.deadiversion.usdoj.gov/drugreg/index.html
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Serah Nnenna Ahuruonye
Nov 30, 2022 2:24pm
| Last reply Dec 1, 2022 5:42am
Reply from Serah Nnenna Ahuruonye
Week One Discussion
Initial Post
Certification and Licensure Plan
Certification and licensure are important legal actions in every industry. Individuals have acquired the required skills and knowledge to perform the tasks they specialize in. During certification and licensure, one demonstrates skills to prove they are prepared to take on the tasks. Besides these benefits, an individual enjoys increased marketability, earning power, a validated reputation, and high self-esteem. In organizations, certification brings a quality standard of practice as stated in the professional code of ethics. In nursing, certification and licensure are no exception. It allows nurses to work after the applicant has met the threshold qualifications. It boosts their confidence. To get quality health care delivery to patients, it is necessary to certify and license nurses.
Getting Certified and Licensed As an APRN in Georgia
In Georgia, an applicant needs to pass a Psychiatric Mental Health Nurse Practitioner Test (PMHNP) before certification and licensure. It is an exam which equips nurses with knowledge of assessing the mental health status of patients by studying their medical history and doing psychiatric examinations (Barbe & Kimble, 2018). It also ensures that factors that may risk a patient’s mental health are solved.
Certification Process
After passing this exam, one can apply for licensure as an advanced practice registered nurse (APRN). This process involves applying to the Georgia Professional Standards Commission (PSC). APRNs are nurses at the graduate level who provide primary care to patients. As an APRN, knowledge of the practical agreement, the scope of practice and prescriptive authority in the respective state is necessary. However, these rules are slightly similar in the APRN consensus model.
Georgia’s board of licensing website
The official website of the board of licensing in Georgia is
https://sos.ga.gov/georgia-board-nursing.
Links to an external site.
Scope of Practice of a Nurse Practitioner
Georgia is a fast-growing state in the US. However, it lags behind in granting APRNs nurses freedom of their practice. In Georgia, a nurse has to work under supervision. This supervision is called the ‘nurse protocol.’ A nurse protocol is a written document outlining the rules that a physician should give an APRN. The physician gives the APRN authority to execute medical operations (Park et al., 2020). More the physician agrees to be available in any immediate consultations required by the APRN
Practice Agreement
A delegate physician conduct reviews of the medical history of patients treated by the APRN. The delegate physicians are bound legally by any mistake made by the APRN. After practising with several APRNs, a nurse protocol agreement is established. A medical doctor signs this. When a patient receives medical attention from an APRN, the patient care, evaluation, nature of practice and any medical issue which may arise is determined by the delegating physician.
Getting A DEA License
Passing the national certification does not grant a nurse practitioner authority to prescribe drugs in Georgia. To get approval, a nurse practitioner should obtain federal permission by applying for a drug enforcement (DEA) number. It is a series of numbers and letters given to an applicant to prove identity (Abbasi et al., 2020). To get a DEA license, a nurse practitioner should apply online on the department of justice website. A credit card, state license information, social security number, and licensure are required in applying.
Prescription Monitoring Program in Georgia
Georgia has a prescription monitoring program (PDMP), a database that provides pharmacists with first-hand patient history information. It helps in the elimination of mistakes due to overprescribing or duplicative prescribing. To make this effective, all prescribers with an active GA professional license and active DEA number must register with GA PDMP. Drug prescription data in schedule II, III, IV, and V should be entered 24 hours after prescription. Patients can also request for a copy of PMDP prescription report.
Nurse Practitioner’s Controlled Substance Prescriptive Authority in Georgia
Nurses Practitioners in Georgia were not mandated to prescribe for patients before 2006. Today, a Georgian nurse practitioner can prescribe drugs to patients. The rules pertaining to this prescription are found in ‘nursing protocol.’ Nurses in Georgia are allowed to prescribe schedule III, IV, and V. They are not allowed to prescribe schedule II drug
Regulation Impacting Nurse Practice Independent Practice
Nurse practitioners in Georgia work under the supervision of a physician. The supervising physician is referred to as a delegating physician. A delegating physician is always available to the NP. They are also responsible for conducting a medical examination and finding the patient’s medical history under the attention of the NP assigned to them. Consequently, they are tied to a mistake made by the NP. A delegate physician can be assigned to several NPs.
References
Abbasi, M., Pishvaee, M. S., & Bairamzadeh, S. (2020). Land suitability assessment for Paulownia cultivation using combined GIS and Z-number DEA: A case study.
Computers and Electronics in Agriculture
,
176
, 105666.
https://doi.org/10.1016/j.compag.2020.105666
Links to an external site.
Barbé, T., & Kimble, L. P. (2018). What is the value of nurse educator certification? A comparison study of certified and noncertified nurse educators.
Nursing Education Perspectives
,
39
(2), 66-71. doi: 10.1097/01.NEP.0000000000000261
Park, J., Han, X., & Pittman, P. (2020). Does expanded state scope of practice for nurse practitioners and physician assistants increase primary care utilization in community health centers?.
Journal of the American Association of Nurse Practitioners
,
32
(6), 447-458. doi: 10.1097/JXX.0000000000000263
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Teresa Kangethe
Nov 30, 2022 12:54pm
| Last reply Dec 1, 2022 5:42am
Reply from Teresa Kangethe
Review practice agreements in your state.
· Identify whether your state requires physician collaboration or supervision for nurse
practitioners, and if so, what those requirements are.
Arizona is a
Full Practice state.
The
State practice and licensure laws permit all NPs to evaluate patients; diagnose, order and interpret diagnostic tests; and initiate and manage treatments, including prescribing medications and controlled substances, under the exclusive licensure authority of the state board of nursing per recommended model by the National Academy of Medicine formerly called institute of medicine, and the National Council of State Boards of Nursing.
Research the following:
o How do you get certified and licensed as an Advanced Practice Registered
Nurse (APRN) in your state?
In Arizona in order to get certified and be licensed as APRN, one need to be a Licensed RN, complete graduate school and pass National Certification exam.
o
What is the application process for certification in your state?
Certification process include:
Application for national certification from an accredited certifying body. Which may include
The American Academy of nurse Practitioners Certification Board (AANPCB). This is a nonprofit independent organization established to provide a valid and reliable program for entry level NPs, Adult Gerontology, Emergency Nurse Practitioner Certification (ENP) and Family NP. These programs are accredited by Board of specialty Nursing Certification ABSNC and the National Commission for Certifying agencies (NCCA)
The American Nurses Credentialing Center (ANCC) have different certification program for specialty with nurses and NP’s
Before sitting for the board exam, it’s recommended to study with some of the advanced accredited education providers such as
FHEA-Fitzgerald Health Education Associates, Inc. (AANP-Approved Provider)
Links to an external site.
APEA-Advanced Practice Education Associates (AANP-Approved Provider)
Links to an external site.
Barkley & Associates (AANP-Approved Provide
Links to an external site.
Registered Nurses seeking certification as a Nurse Practitioner or Certified Nurse Midwife only shall meet the following requirements:
Current Arizona RN license in good standing OR current RN license with multistate privileges in another compact state.
An official transcript directly from the institution attended that provides evidence of:
A graduate degree with a major in nursing for RNP and CNS applicants.
An official letter sent directly from the program to AZBN, stating the role and population focus of the program.
The educational program was:
Part of a graduate degree/post-master’s program at an accredited institution; OR
The program was approved or recognized in the U.S jurisdiction of program location for the purpose of granting APRN licensure or certification.
National Certification or re-certification as an APRN in the role and population focus if certification was issued after 7-1-2004. Exception: a CNS granted a waiver of certification.
Meets practice requirement by verifying they have:
Completed an advanced practice nursing education program within the past five years; or
Practiced for a minimum of 960 hours within the past five years where the nurse:
Worked for compensation or as a volunteer, as an APRN: OR
Held a position for compensation or as a volunteer that required, preferred or recommended in the job description, the level of advanced practice certification being sought or renewed.
If the applicant satisfies all other requirements, the Board shall continue to certify:
An RNP without a graduate degree with a major in nursing if the applicants:
Meets all other requirements for certification; and
Ensures that the U.S jurisdiction of an applicant’s previous RNP licensure/certification submits evidence of certification or licensure in the NP role and population focus that either is current or was current at least six months before the application was received by the board, and was originally issued:
Before 1-1-2001, if the RNP applicant lacks a graduate degree; or
Before 11-13-2005 if the RNP’s graduate degree is in a health-related area other than nursing.
An RNP or CNS applicant without evidence of national certification who received initial APRN certification/licensure in another state before 7-1-2004 and provides evidence, directly from the jurisdiction, that the certification/licensure is current.
A CNS applicant without evidence of completion of a CNS program who received initial certification of advanced practice licensure in this or another state before 11-13-2005 and provides evidence, directly from the jurisdiction, that the certificate/license is current.
A CNS applicant who completed a women’s health clinical nurse specialist program that was part of a graduate degree in a nursing program without evidence of national certification upon submission of the following:
A description of the applicant’s scope of practice that is consistent with the Nurse Practice Act definition
R4-19-514
Links to an external site.
.
One of the following:
A letter from a faculty member who supervised the applicant during the graduate program attesting to the applicant’s competence to practice within the defined scope of practice; OR
A letter from a current supervisor verifying the applicant’s competence in the defined scope of practice; OR
A letter from a physician, RNP, or CNS who has worked with the applicant within the past 2 years attesting to the applicant’s competence in the defined scope of practice and
Verification that the applicant has practiced a minimum of 500 hours in the population focus within the past 2 years, which may include clinical practice time in a CNS program.
Application Fees
All fees are in U.S. dollars and are non-refundable.
Application Fee: $150.00 (required)
Fingerprint Fee: $ 50.00 (required)
Temporary Certification Fee: $ 35.00 (optional)
Prescribing and Dispensing Fee: $150.00 (optional), for RNP’s only
You are required to complete and submit a fingerprint card. NOTE: If you have had previous fingerprinting done with another agency, you must still submit a new set of fingerprints to AZBN. A copy of a clearance card issued by DPS is not a substitute for this requirement. If you have submitted previous fingerprints to the AZ State Board of Nursing within the past 2 years, you will not need to submit fingerprints again. Return the completed fingerprint card with your application to the Board in a large envelope. DO NOT fold the fingerprint card.
It can take approximately 8-12 weeks to receive fingerprint results. You cannot receive permanent licensure until these results are received. Fingerprint Clearance Cards are not acceptable.
All applicants must submit a copy of documentation regarding citizenship/nationality/alien status. A copy of the document must be submitted on an 8 1/2 x 11 sheet of plain white paper and submitted with the application. For a list of acceptable documents see
Citizenship and Alien Status.
Links to an external site.
o What is your state’s board of nursing website?
https://www.azbn.gov/
o
How does your state define the scope of practice of a nurse practitioner?
If you are certified in Arizona and hold national certification as a registered nurse practitioner (RNP) or certified nurse midwife and have prescribing and dispensing authority, you are allowed to
prescribe drugs and devices
. RNP
cannot performing surgical procedures independently.
Arizona’s Nurse Practitioner Supervision Laws
Arizona does not require nurse practitioners to be supervised by, or collaborate with, a physician. Rather, NPs in Arizona are free to practice independently. Within this legal standing, the
Arizona Nurse Practice Act
Links to an external site.
does give nurse practitioners some guidelines.
While NPs may practice without supervision, Arizona State Law requires nurse practitioners to refer patients falling outside of the NP’s knowledge and experience to a physician or another healthcare provider. Or, the NP may consult with another provider regarding the patient in question.
Additionally, the Arizona Board of Nursing specifies that nurse practitioners are only to practice in their area of certification, they should not “exceed the limits” of their advanced practice specialty area. Furthermore, nurse practitioners “shall only provide health care services including prescribing and dispensing within the NP’s population focus and role for which the NP is educationally prepared”. Educational preparation includes academic coursework or continuing education including theory and supervised practice in the specialty area.
Arizona is one of many states that recognizes the value of nurse practitioners to the healthcare system, and in doing so has allowed NPs freedom in their practice.
o
What is included in your state practice agreement?
If you are certified in Arizona and hold national certification as a registered nurse practitioner (RNP) or certified nurse midwife and have prescribing and dispensing authority, you are allowed to
prescribe drugs and devices
. RNP
cannot performing surgical procedures independently.
While NPs may practice without supervision, Arizona State Law requires nurse practitioners to refer patients falling outside of the NP’s knowledge and experience to a physician or another healthcare provider. Or, the NP may consult with another provider regarding the patient in question.
Arizona’s Nurse Practitioner Supervision Laws
Arizona does not require nurse practitioners to be supervised by, or collaborate with, a physician. Rather, NPs in Arizona are free to practice independently. Within this legal standing, the
Arizona Nurse Practice Act
Links to an external site.
does give nurse practitioners some guidelines.
o
How do you get a DEA license?
Arizona’s Nurse Practitioner Prescribing Laws
Similar to supervision laws, nurse practitioners practicing in Arizona may prescribe without physician collaboration or supervision. In order to prescribe, NPs must first apply for
prescribing authority from the Arizona Board of Nursing
Links to an external site.
. This includes completion of 45 hours of education in pharmacology or drug therapy in the three years preceding the application. Then, the nurse practitioner must apply for a DEA number if he/she wishes to prescribe controlled substances. Once prescribing authority is granted, it can only be used in Arizona, NPs cannot prescribe in other states.https://www.deadiversion.usdoj.gov/
o
Does your state have a prescription monitoring program (PMP)?
The Arizona Controlled Substances Prescription Monitoring Program (CSPMP) is the standard of practice and best practice to ensure patients are receiving appropriate and safe medications. It has proven to be one the most promising state-level interventions to improve opioid prescribing, inform clinical practice, and protect patients at risk.
o
How does your state describe a nurse practitioner’s controlled-substance
prescriptive authority, and what nurse practitioner drug schedules are
nurse practitioners authorized to prescribe?
While nurse practitioners have the freedom to prescribe without supervision, Arizona Law includes many
prescribing regulations
Links to an external site.
. These regulations include:
NPs may prescribe but may not include refills on prescriptions for Schedule II controlled substances
For Schedule III or IV medications, NPs may prescribe a maximum of five refills in six months
Prescriptions for Schedule V drugs may include refills for up to one year
All prescriptions must include the nurse practitioner’s name, address, phone number, population focus, and date.
In Arizona, nurse practitioners are prohibited from prescribing controlled substances to themselves or family members. Prescribing must occur within a professional relationship in which the NP has examined the patient with
a few exemptions
Links to an external site.
, for example in emergency situations. Nurse practitioners practicing in Arizona are allowed to dispense medication samples.
References
Malloch, K., Hrabe, D. P., & Schultz, M. (2020). Innovation Leaders:: Networking Across Practice and Regulatory Agencies for Better Data and Clinical Efficiency.
Nurse Leader
,
18
(3), 269–275.
https://doi.org/10.1016/j.mnl.2020.03.015
Links to an external site.
smith V. (2009). Healthcare serial offenders…article reprinted from the Arizona Board of Nursing Regulatory Journal (September 2008, Volume 3, Number 3), with permission.
KBN Connection
,
19
, 15–19.
Ridenour J. (2004). Speaking up could save lives…Reprinted with permission from Arizona State Board of Nursing Newsletter, Vol 5, No. 1, February, March, April 2004.
Virginia Nurses Today
,
12
(2), 11–12.
https://www.azbn.gov/
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Saffie Conteh
Nov 30, 2022 12:26pm
| Last reply Dec 3, 2022 1:17pm
Reply from Saffie Conteh
Nurse Practitioners in Virginia
Saffie Conteh
Walden University
Dr. Madeleine
NRNP-6675
11/30/2022
Nurse Practitioners in Virginia
Practice Agreements in Virginia
In Virginia, practice agreement is defined in 18VAC90-40-90. It describes the activities which the nurse practitioner is allowed to do under the law. The nurse practitioner is authorized to prescribe medication but must be accompanied by a written practice agreement with a physician. The agreement defines the prescriptive authority the law allows the nurse practitioners to complete. 54.1-2957.01 of the Code of Virginia defines authorization concerning different drugs and devices (
18VAC90-40-90. Practice agreement
, n.d.). The physician’s signature is also needed to allow the nurse practitioner to complete the given tasks.
Physician Collaboration or Supervision
In Virginia, nurse practitioners work under a collaborative agreement with physicians who allow prescriptive authority. The signature of the physician collaborating with the physician has to be listened to in the contract (
Nurse practitioner
, n.d.). A written or electronic practice agreement must be provided, thus showing the nurse practitioners permission to collaborate with the physicians.
Certification and Licensure as an Advanced Practice Registered Nurse (APRN)
In Virginia, nurse practitioners must get their education and graduate to be baccalaureate-prepared registered nurses. They must finish an accredited master’s degree program, including twenty-four months of coursework and 800 hours of clinical experience. The nurses must pass certification examinations (
Nurse practitioner
, n.d.). At the graduate-level programs, the nurses must undertake practitioner programs. The licensure is renewed after taking the needed training.
The Application Process for Certification
The application starts with acquiring the application form, which can be done physically or online. The applicant has to fill out and submit the form. A non-refundable application fee must be paid with the form submission. The applicant must submit a college verification form showing they have achieved the educational requirements. A report on the experience is also required. The assessment scores are also needed to ensure that the applicant has met the requirements.
State’s Board of Nursing Website
https://www.vhwda.org/healthcare-careers/nursing/nurse-practitioner/#:~:text=To%20become%20a%20nurse%20practitioner,experience%2C%20and%20pass%20certification%20examinations
Links to an external site.
.
The Scope of Practice of a Nurse Practitioner
In Virginia, the scope of practice defines the duties that nurse practitioners are expected to complete in their daily work. Nurse practitioners must collect detailed health information about the patients they encounter daily during physical exams. They are expected to diagnose the patients and create treatment plans. Nurse practitioners must treat common acute conditions, minor injuries, and illnesses. They oversee providing the health management of chronic diseases. In such cases, they must create relationships with the clients and make sure that they develop treatment plans based on the specific needs of the patients (
Nurse practitioner
, n.d.). The nurse practitioners oversee prescribing prescriptions but under the collaboration of physicians. The nurses provide health education to patients and families, thus promoting treatment alternatives and promoting health.
What Is Included in the Virginia Practice Agreement
The agreement has several inclusions that define the practice guide. The nurse practitioners in Virginia require the authority of the nurse practitioners in prescribing medication. The physicians give their authorization through the written agreement, and if the prescription change is needed, they must ensure that the deal is revised. The physician is supposed to serve only less than six nurse practitioners (
18VAC90-40-90. Practice agreement
, n.d.). The agreement also provides several exceptions. The first is the exception of the nurse practitioners serving as certified nurse midwives, who can prescribe medication for two years before they can get into a practice agreement. The second exception is that of the clinical nurse specialists who can prescribe Schedule VI controlled substances (Virginia Law, 2022).
DEA License
The nurse practitioners must apply the licensure from the
US Department of Justice website. The applicant had to pay a registration fee of $551
, which covers three years (Virginia Law, 2022). The applicants must show their licensure and certification as nurse practitioners and be aligned with a particular physician or health center.
Prescription Monitoring Program (PMP)
Virginia’s Prescription Monitoring Program (PMP) is a database accessible 24/7 with information on dispensable controlled substances listed in Schedule II, III, and IV. The database also contains information about Schedule V, where the prescription is needed. All other drug concerns are found in the database. The program’s primary purpose is to promote safe medication prescription and dispensation practices for substances that are not covered through essential information that allows the providers to make informed decisions. The databases apply to both providers and law enforcement.
A Nurse Practitioner’s Controlled-Substance Prescriptive Authority
Under the 54.1-2957.01 code, the nurse practitioners in Virginia have the power to prescribe controlled substances. They can use the Drug Control Act (§ 54.1-3400 et seq.) in prescription or provide manufacturing samples from professionals about the controlled substances (Virginia Law, 2022). They are allowed to prescribe Schedules II through VI controlled substances.
References
18VAC90-40-90. Practice agreement
. (n.d.). Virginia Law. Retrieved from:
https://law.lis.virginia.gov/admincode/title18/agency90/chapter40/section90/
Links to an external site.
Nurse practitioner
. (n.d.). Virginia Health Workforce Development Authority. Retrieved from:
https://www.vhwda.org/healthcare-careers/nursing/nurse-practitioner/#:~:text
Links to an external site.
Virginia Law. (2022).
§ 54.1-2957.01. prescription of certain controlled substances and devices by licensed nurse practitioners
. Retrieved from:
https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2957.01/
Links to an external site.
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Laura Assanga Eyong
Nov 30, 2022 11:36am
| Last reply Dec 2, 2022 3:11am
Reply from Laura Assanga Eyong
Introduction
The latter stages of a nursing student’s advanced nurse practitioner degree include certification and licensure. The learner must consider the certificate that will be required based on their personal preferences. The RN with advanced practice (APRN). Students choose between two certification options, including those offered by the American Nurse Credentialing Center (ANCC) and the American Association of Nurse Practitioners (AANP). Although certification may not be needed in every state, it is necessary nationwide for APRNs to participate in Medicare and Medicaid . (Alleman, K., & Houle, K. (2013). After certification is complete, APRNs must get a license to practice in the state where they will be employed. The goal of this talk is to investigate the licensing procedure in the state where the APNs want to practice and comprehend the laws and rules in that jurisdiction.
Advanced Practice Registered Nurse Certification in the State of Maryland
Practitioners must have an RN license, graduate from an accredited university, attend AANP accredited review courses, and pass the NP state certification board exam
.
Maryland State grants nurse practitioners (NP) the independence to operate their practices without the direction of doctors. Nurses work closely with doctors, and they are required to show that they have a doctor scheduled for consultation by presenting a one-page agreement (Iglehart, 2015). The new regulation enables the NP to independently make diagnoses, prescribe medications, and possibly provide treatment. Maryland acknowledges that NPs possess the necessary training, expertise, and experience to deliver high-quality care without the guidance of doctors. The state defines the NP’s scope of practice as a complete practice authority, allowing nurses to freely carry out their practice as long as they sign a document attesting that they have a doctor on staff who serves as a consultant. The state practice agreement includes several obligations.
What is the application process for certification in your state?
Practitioners must be asked if they have a current or inactive license with the state. They must have a signed agreement. They must have a supervising doctor for 18 months based in Maryland the date of application. Also, one must finish a nurse practitioner program and pass a test that has been approved by the Board(Alleman, K., & Houle, K. (2013). Additionally, the NP must be certified by state- and board-recognized organizations. An application form must be submitted to the Board as part of the procedure. Along with meeting the requirements for education and experience, one must also pass the Board test.In Maryland, NPs are required to hold a graduate degree as well as a Master’s or post-degree. Master’s The US Department of Education (USED)-recognized accreditation organizations must be used for the nursing programs. The “Maryland Board of Nursing” mandates that advanced courses in physiology, pharmacology, or health assessment be taken by APRNs.A graduate must submit college transcripts, a copy of their national certification, $50 in application costs and $25 for any additional area of certification, and an attestation form that has been approved by a coworker when they apply for their certification. Th processing time is takes 2-4 weeks with no additional documentation is needed.
What is your state board of nursing website?
The website address for the Maryland Board of Nursing is https://mbon.maryland.gov. The website details the certification process and other prerequisites for graduates who wish to work as nurses in the state.
How does your state define the scope of practice of a nurse practitioner?
Maryland’s scope of practice is codifying NP,s authority to prescribe medication-assisted treatment. It also seeks to discuss whether NPs can prescribe medication without physician oversight (Alleman, K., & Houle, K. (2013). Additionally, the board reviews whether NP can diagnose a patient’s illness without referring them to other medical personnel. Now, NPs can diagnose and treat patients with or without a physician’s oversight. The “Maryland Nurse Practice Act (NPA),” which outlines the APRN’s scope of practice, directs the state practice agreement. As of 2010, Maryland is one of the states that allows NPs to practice independently with a one-page agreement that they have physicians line up to consult if needed.
What is included in your state practice agreement?
Before the state of his/her, the NP is required to sign an agreement. In the document, the NP must put her name and her license number, together with the names and license numbers of the doctors who will supervise her directly or through the phone. The agreement must be submitted together with an attestation form, plus authorization to sit for the board exam
.
According to this law, the NP may independently practice while working with the doctor (Phillips, S. J. (2019)..
How do you get a DEA license?
The “Maryland State Controlled Dangerous Substance Registration (CDS” is required before applying for a DEA with the office of controlled substances administration( OCSA). A practitioner must fill out questionnaires for researchers and an application form during this process(Maryland Department of Health, 2020a). Once accepted, a person can use the state license number to apply for a federal DEA license. As a result, the state must first determine if a graduate is qualified before issuing a license that can be used to apply for IDEA.
Does your state has a prescription monitoring program (PMP)
The “prescription drug monitoring program (PDMP)” in Maryland assists patients and healthcare professionals in ensuring the efficient and secure use of prescription medications. The PDMP provides reliable information on pharmaceuticals containing restricted substances, enhancing the prescriber’s capacity to lower the risks associated with dispensing dangerous medications (Maryland Department of Health, 2020b). This initiative aims to reduce drug-related overdoses that could compromise patient safety.
How does your state describe a nurse practitioner,s controlled substance prescription authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe
?
The Maryland prescriptive authority for controlled substances is governed by regulations. NPs need to have additional education, such as “coursework in advanced” pathophysiology or pharmacology, to prescribe controlled medications (American Medical Association, 2017). Additionally, to obtain a prescription authority for restricted substances, an NP needs a “Maryland Drug Control Number.” Only schedules 2, 2N, 3, 3N, 4, and 5 of controlled substances may be “administered” in Maryland by NP. (Phillips, S. J. (2019). They don’t have prescriptive jurisdiction over schedule 1, a class of prohibited medications that are not permitted for medical use in the US. The NP must, however, first adhere to state regulations, which include registering and getting a drug control number.
Conclusion
It was intriguing and educational to conduct research on the state of Maryland APRN’s scope of practice. I was taken aback by how limited the state of Maryland is regarding APRN practice. I have consistently assumed that the APRN is capable of practicing alone. My knowledge of the state of Maryland’s requirements for certification and license and the APRNs’ scope of practice has been enriched by the research done for this topic (Alleman, K., & Houle, K. (2013).
References
(1). Alleman, K., & Houle, K. (2013). Advanced practice registered nurse certification.
Nephrology Nursing Journal : Journal of the American Nephrology Nurses’ Association; Nephrol Nurs J, 40
(3), 219.
https://wrlc-hu.primo.exlibrisgroup.com/permalink/01WRLC_HOW/1o61gqe/cdi_proquest_miscellaneous_1419339680
Links to an external site.
(2). American Medical Association. (2017).
State law chart: Nurse practitioner prescriptive authority
.
https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/specialty%20group/arc/ama-chart-np-prescriptive-authority.pdf
Links to an external site.
(3). Iglehart, J. K. (2015). Expanding the role of advanced nurse practitioners–risks and rewards.
The New England Journal of Medicine
,
368
(20), 1935.
http://www3.med.unipmn.it/intranet/papers/2013/NEJM/2013-05-16_nejm/nejmhpr1301084.pdf
Links to an external site.
(4). Maryland Department of Health. (2020a).
Latest news and information.
https://health.maryland.gov/ocsa/Documents/Applications%20Instructions%20(Pra.Revised%209-25-2018).pdf
Links to an external site.
(5). Maryland Department of Health. (2020b).
Maryland prescription drug monitoring program
.
https://health.maryland.gov/pdmp/Pages/Home.aspx
Links to an external site.
(6). Phillips, S. J. (2019). 31st annual APRN legislative update: Improving state practice authority and access to care. Nurse Practitioner, 44(1), 27–33. https://doiorg.ezp.waldenulibrary.org/10.1097/01.NPR.0000550248.81655.30.
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Kately Anne Sylvia
Nov 30, 2022 4:48am
| Last reply Dec 2, 2022 4:48pm
Reply from Kately Anne Sylvia
Main Discussion Post: Week 1
Certification and Licensure Plan
Introduction
This week’s discussion is about the application process for certification and licensing as a Psychiatric Mental Health Nurse Practitioner (PMHNP) in the state of which I will practice. In addition, the state’s board of nursing will be identified, the state’s scope of practice of a nurse practitioner will be discussed, and what is included in the state practice agreement. Furthermore, it will be explained how to get a Drug Enforcement Agency (DEA) license, and if Maryland has a prescription monitoring program (PMP). Last, it will be described if Maryland has a nurse practitioner’s (NP) controlled-substance prescriptive authority and what drug schedules NPs are authorized to prescribe.
Application Process for Certification and Licensure
In the state of Maryland, the criteria for nurse practitioner certification is to have an active registered nursing license, complete a certification application and declaration of residency form, send a sealed official transcript to the Maryland Board of Nursing (MBON) and send a current national certification or a letter of eligibility to take the certification exam (Maryland Board of Nursing, 2015). Furthermore, all NP programs must be approved by the MBON, which Walden University is approved. Also, a NP graduate supervision agreement needs to be signed by all preceptors and sent with the application. There is a non-refundable $50 initial NP certification application fee from the MBON, and the processing time is 2-4 weeks (Maryland Board of Nursing, 2015).
The American Nurses Credentialing Center (ANCC) is where to apply for the PMHNP certification exam to get licensed. Prometric via ProScheduler is the website to schedule the PMHNP exam to get licensed in the state of Maryland (2022). The test can be taken at a Prometric testing center or “through a remotely proctored internet enabled location of your choice where you must provide a computer with a camera, microphone and an internet connection” (Prometric, 2022).
Maryland State Scope of Practice of Nurse Practitioners
In Maryland, a NP will have full practice authority after having a “regulated collaborative relationship” for 18 months with a NP or doctor who has full practice authority (Scope of Practice Policy, 2022). After this, a NP may practice independently including the following roles and responsibilities, but this is not an all-inclusive list (Scope of Practice Policy, 2022):
Conduct a comprehensive physical assessment of an individual;
Establish a medical diagnosis for common chronic stable or short-term health problems;
Order, perform, and interpret laboratory tests;
Prescribe drugs as provided under § 8-508 of this title;
Perform diagnostic, therapeutic, or corrective measures;
Consult and collaborate with, or refer an individual to, an appropriate licensed physician or any other health care provider as needed; and
Provide emergency care
The Maryland Board of Nursing website is the following: https://mbon.maryland.gov/. The website provides information, forms and links for getting started for the application process for certification.
Drug Enforcement Agency license and Prescription Drug Monitoring Program
In 1970, the Controlled Substances Act made drug scheduling mandated; title II of the law addresses controlled substances (Lopez & Tadi, 2021). The United States Drug Enforcement Agency (DEA) has a list of controlled substances from scheduled I to V with schedule I drugs having the highest risk for abuse and schedule V having the lowest potential for abuse (Lopez & Tadi, 2021).
As a new applicant to get a DEA license, you can register online at the Drug Enforcement Administration Diversion Control Division at the following website: https://apps.deadiversion.usdoj.gov/webforms2/spring/main?execution=e1s1. There are 6 sections to fill out, and the cost is $888 for 3 years and is non-refundable (Drug Enforcement Administration Diversion Control Division, n.d.).
Maryland has a prescription drug monitoring program (PDMP). In the United States, drug abuse is substantially correlated with patient morbidity and mortality (Rutkow et al., 2015). PDMPs “have emerged as one of the principal interventions that states have adopted to address this epidemic. These programs are state-specific electronic databases that collect, analyze, and report information on the prescribing and use of controlled substances (Rutkow et al., 2015).
Controlled-Substance Prescriptive Authority and Drug Schedules NPs can Prescribe
NPs cannot autonomously prescribe scheduled II to V drugs until after practicing under a licensed NP or doctor for 18 months. Furthermore, NPs need to have completed the following classes to have controlled substance prescriptive authority: advanced pharmacology, advanced physical assessment and advanced pathophysiology (American Medical Association, 2017). Last, a NP must have Maryland Drug Control number from the DEA to prescribe controlled substances (American Medical Association, 2017).
Conclusion
Upon graduating from the PMHNP program at Walden University it is important to have knowledge about the application process, how to register for the national board exam and how to apply for DEA licensing. While in practice, it is also important to initially learn about the NPs scope of practice in Maryland, the PDMP, and NPs controlled-substance prescriptive authority and what drug schedules NPs are authorized to prescribe in this state. Last, nothing was surprising about the research in this discussion. The information was easy to identify and understand.
References
American Medical Association. (2015).
State law chart: Nurse practitioner prescriptive authority
. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.ama-
assn.org/sites/ama-assn.org/files/corp/media-browser/specialty%20group/arc/ama-chart-np-prescriptive-authority.pdf
Justia: US Law. (2022).
MD Health Occ Code § 8-101. https://law.justia.com/codes/maryland/2016/health-occupations/title-8/subtitle-1/section-8-101/
Lopez, M. J., & Tadi, P. (2021). Drug enforcement administration drug scheduling. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK557426/
Maryland Board of Nursing. (2020).
Advanced practice registered nurse: Nurse practitioners
. https://mbon.maryland.gov/Pages/adv-prac-nurse-practitioner-index.aspx
Prometric. (2022).
American nurses credentialing center
. https://www.prometric.com/ancc
Rutkow, L., Turner, L., Lucas, E., Hwang, C., Alexander, G. C.. (2015). Most primary care physicians are aware of prescription drug monitoring programs, but many find the data difficult to access.
Health Affairs, 34
(3). https://doi.org/10.1377/hlthaff.2014.1085
Drug Enforcement Administration Diversion Control Division. (n.d.).
Application for registration under controlled substances Act of 1970 (New applicants only)
. https://apps.deadiversion.usdoj.gov/webforms2/spring/login?execution=e1s1
Note: when I copied and pasted my discussion post onto this page, my format got messed up. I cannot get it to double space and my hanging indentation for my references disappeared. I am sure there are other formatting issues I have not noticed yet. Thank you.